I am a 30 year old male. No history of autoimmune disease in the family.

My symptoms are basically strong joint pain in the fingers, wrists, feet, toes, and knees. The pain began in February and has continued until now. It is worse at nights. I have a very small amount of morning stiffness, not much at all. Some days I have no detectable morning stiffness.

I am under the care of a rheumatologist. Here are my results. RF = negative, Anti-CCP = negative, CRP = negative, ESR = 7 (negative). X-ray = negative for joint damage and inflammation. MRI with contrast = negative for synovitis and tenosynovitis, negative for inflammation, reported as "no objective signs of RA." My rheumatologist has conducted the "squeeze" test and has not been able to detect any swelling or inflammation in my fingers. So she is reluctant to proceed with RA treatment.

There is one other confounding variable. I was found to have a positive ANA (1:40) and elevated Thyroid antibodies ( > 1000). My TSH was tested and was high out of spec at 6.1, however I have no symptoms of hypothyroidism other than the joint pain. No fatigue, no constipation, no brain fog, no weight gain, no brittle nails, etc.

My question for the group is, how likely is it that this could be RA without there being any objective evidence? I understand that the blood work comes back negative in about 20% of RA patients. Is the same true for inflammation? In other words, do RA cases at times present themselves with pain but no objective signs of inflammation? Have any patients here experienced a similar manifestation of joint pain? If so, what did the issue turn out to be? Thanks for any answers.

I am considering getting thyroid treatment to lower my TSH levels to see if that helps the joint pain, but I am skeptical given that I have no other hypothyroid symptoms. Also, I really don't want to screw around with my thyroid until I have to.

Without the ability to show doctors at least *some* kind of objective evidence for RA (rather than symptom report), it seems that few doctors will want to go the route of prescribing a DMARD. At the same time, my fear is that I am in an early window of RA that could have a very good outcome if I act now, and that by experimenting with other possibilities (i.e,. taking thyroid meds for a month to bring down TSH and see if that helps the joint pain), I am compromising that window.

I am relatively new to this forum myself and have PMR (polymyalgia rheumatica), an auto-immune disease in the same family as RA. PMR generally attacks older people, not someone your age.

However, in reading these forums, I would suggest looking up "sero-negative RA". I have read a number of posts where members say that their lab work does not match their symptoms (lab is negative or does not point to the disease). Many rheumys treat their patients symptomatically.

Good luck and welcome to this forum. I think others will post after the holiday with more helpful information.

Some people don't have a lot of symptoms of hypothyroid but once you start on thyroid replacements, your joint pains may go away. If your TSH is elevated you are hypothyroid and need treatment meds. They start you off slow, so don't worry. It's interesting that you are a guy, hypothyroid happens more often in women. I have a positive ANA with all other tests negative (except for thyroid) but my doc is treating me for inflammatory arthritis. He did see some changes on my x-rays. He said he treats the symptoms not the lab tests for arthritis. After 3 months on plaquenil, I finally have some relief. I also have hypothyroid and that can cause aches and pains too. I hope you get some relief soon from your joint pain.d 1/09 with colitis sigmoid colon with some diverticular disease as well, IBS, Colon resection Nov. 2010, now in remission inflammator arthritis, asthma, skin scleroderma, VSL#3 probiotic, Vit. D, nexium, pexeva (paxil), synthroid, cozar, advair, plaquenilBlood test positive for Crohn's via prometheus ibd serology panel ASCA. Positive ANA speckled pattern

Find a good endocrinologist for the hypothyroid treatments, my daughter also shows no signs of thyroidproblems yet she is hypo from her blood work. I constantly have lower blood pressure readings than she does.Hope your feeling better soon....********************************************** * So many dx's I could write a book* "It would be nice if we could use the edit button in real life"...********>^..^^..^

My hubby has an underactive thyroid and before he was diagnosed he would get terrible joint pains. Often hot to touch but no swelling. Very strange. Once on thyroxin it all disappeared.I have sero negative RA. I started out with aching joints like the flu and also had high ANA results but nothing else. My doctor started me on anti inflammatories and when they didn't work sent me on to the rheumy about 2 months later by that time my knees had swollen but all my other joints were fine.I get the feeling we all present with a different range of symptoms and only the rheumys really can diagnose you properly. Lots of auto immune diseases affect joints, I know thyroid conditions are auto immune based so it could be your thyroid. You're going to have to go with the specialists and their gut reactions. You don't want to take DMARDS if you don't need them .Goodluck with it all, I hope for yoursack its not RA but thyroid based. But we're always here to listen if you need us, golitho